Meet Your Verve Ambassador! Name(Required) First Last Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Preferred Phone Number(Required)Preferred Email(Required) Are you new to Westchester County (moved within the last year)? Yes No How did you first hear about the Verve Ambassador program?JCCMW programmingFriends/FamilyEmailSynagogueSocial MediaOtherWhat types of programming would you like to attend with your family? Shabbat Dinners Lectures Literary Events Israeli Dancing Community Groups Art Workshops Skill-Building Classes Film Screenings Wellness Programs In the past few years, have you participated in any programs at the JCCMW?YesNo
